Centenary of the first trans-sphenoidal surgery of the hypophysis (Hermann Schloffer 1907) and its echoes within Croatian neurosurgical practice

Fatović‐Ferenčić, Stella; Gnjidić, Živko

doi:10.1007/s10354-007-0493-8

Cited by 7 publications

(7 citation statements)

References 6 publications

(4 reference statements)

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“…Endoscopic skull base surgery (ESBS) represents a rapidly growing field with ever‐evolving methodologies. The roots of ESBS can be traced back to the first decade of the twentieth century but experienced no rapid advancement until the 1990s . Advances in endoscopic imaging technologies, newer surgical instrumentation, and the development of multi‐specialty four‐handed techniques have allowed the scope of ESBS to advance at a remarkable rate while improving safety, efficacy, and morbidity …”

Section: Introductionmentioning

confidence: 99%

Survey of endoscopic skull base surgery practice patterns among otolaryngologists

Wannemuehler

Rabbani

Burgeson

et al. 2018

Laryngoscope Investig Oto

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BackgroundEndoscopic skull base surgery (ESBS) is a rapidly expanding field. Despite divergent reported preferences for reconstructive techniques and perioperative management, limited data exist regarding contemporary practice patterns among otolaryngologists performing ESBS. This study aims to elucidate current practice patterns, primarily the volumes of cases performed and secondarily a variety of other perioperative preferences.MethodsAn anonymous 32‐item electronic survey examining perioperative ESBS preferences was distributed to the American Rhinologic Society membership. Statistical significance between variables was determined utilizing Student t, chi‐square, and Fisher exact tests.ResultsSeventy otolaryngologists completed the survey. The effective response rate was approximately 22.5%. Sixty percent of respondents were in full‐time academic practice and 70% had completed rhinology/skull base fellowships. Annually, 43.3 mean ESBS cases were performed (29.1 private practice vs. 52.9 academic practice, P = .009). Academic practice averaged 24.1 expanded cases versus only 11 in private practice (P = .01). Of respondents, 55.7% stood on the same side as the neurosurgeon and 72.9% remained present for the entire case. Current procedural terminology coding and antibiotic regimens were widely divergent; 31.4% never placed lumbar drains preoperatively, while 41.4% did so for anticipated high‐flow cerebrospinal fluid leaks. While considerable variation in reconstructive techniques were noted, intradural defect repairs utilized vascularized flaps 86.3% of the time versus only 51.3% for extradural repairs (P < 0.001). Major complications were rare. Postoperative restrictions varied considerably, with most activity limitations between 2–8 weeks and positive airway pressure use for 2–6 weeks. Most respondents started saline irrigations 0–2 weeks postoperatively.ConclusionsBased on responses from fellowship‐ and non‐fellowship‐trained otolaryngologists in various practice settings, there remains considerable variation in the perioperative management of patients undergoing ESBS.Level of Evidence5

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Section: Introductionmentioning

confidence: 99%

Survey of endoscopic skull base surgery practice patterns among otolaryngologists

Wannemuehler

Rabbani

Burgeson

et al. 2018

Laryngoscope Investig Oto

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“…After assuming a full professorship, they would likely be promoted to a senior or chair position at a smaller university before finishing their careers as a senior professor or departmental chair at another large university in a major city, usually either Prague, Budapest, or Vienna. 18 Schloffer's career followed this pattern. He started his training at the University of Graz, a smaller city, finished his training and obtained his professorship at the University of Prague, and in 1903, he left the University of Prague to assume the role of director of surgery at the University of Innsbruck in Austria, a comparatively smaller institution (Fig.…”

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confidence: 87%

“…It is here that Schloffer's academic career took flight. 18 Starting only as a volunteer, Schloffer was quickly promoted after 1 year to the status of first assistant in the surgical clinic. Schloffer maintained his status as first assistant for the next 5 years, continuing his training.…”

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confidence: 99%

“…In the following years he continued to work at the University of Prague as a manager of the surgical clinic, where he assumed both a practicing and a teaching role. 5,18 In 1902, Schloffer was finally appointed as a full professor at the University of Prague; however, he did not remain there for long. In the academic environment of Austria at that time, it was customary for professors to tour through multiple universities in various settings.…”

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confidence: 99%

“…Narath, another protégé of Billroth and contributor to the development of hernia surgery, was initially offered the position but turned it down, instead assuming the position of chair of surgery at the University of Heidelberg 3 years later. 18 Although Innsbruck was a much smaller institution than the one in Prague, it offered Schloffer the chance to per- form his own academic research and develop his own practice. Most notably, it was at Innsbruck that Schloffer performed the first transsphenoidal pituitary surgery on a living patient, paving the way for the future of pituitary surgery.…”

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confidence: 99%

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Hermann Schloffer and the origin of transsphenoidal pituitary surgery

Schmidt

Choudhry

Takkellapati

et al. 2012

FOC

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A little over a century ago, in 1907, at the University of Innsbruck, Hermann Schloffer performed the first transsphenoidal surgery on a living patient harboring a pituitary adenoma. Schloffer used a superior nasal route via a transfacial lateral rhinotomy incision. This was perhaps his greatest academic contribution to neurosurgery. Despite the technological limitations of that time, Schloffer's operation was groundbreaking in that it laid the foundation for future development and refinement of transsphenoidal pituitary surgery, influencing prominent surgeons such as Oskar Hirsch and Harvey Cushing. Even after undergoing multiple modifications and a brief fall into obscurity, the transsphenoidal approach has endured through generations of surgeons and remains the preferred approach for lesions of the sella turcica to this day. Although Schloffer performed primarily abdominal surgery in his practice, his contributions to the transsphenoidal approach have had a lasting impact in the field of pituitary and skull base surgery. The authors review the life and career of Hermann Schloffer, the surgical details of his transsphenoidal operation, and the legacy that it has left on the field of pituitary surgery.

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Combined endoscopic and microscopic management of pediatric pituitary region tumors through one nostril: technical note with case illustrations

et al. 2008

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Centenary of the first trans-sphenoidal surgery of the hypophysis (Hermann Schloffer 1907) and its echoes within Croatian neurosurgical practice

Cited by 7 publications

References 6 publications

Survey of endoscopic skull base surgery practice patterns among otolaryngologists

Survey of endoscopic skull base surgery practice patterns among otolaryngologists

Hermann Schloffer and the origin of transsphenoidal pituitary surgery

Combined endoscopic and microscopic management of pediatric pituitary region tumors through one nostril: technical note with case illustrations

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